Cefaclor remains a useful beta-lactam when beta-lactamase coverage is needed after amoxicillin failure. These pearls help clinicians deploy it safely and effectively.
Reserve cefaclor for otitis media or sinusitis after first-line amoxicillin/clavulanate failure or documented beta-lactamase producers—check local antibiogram annually.
Extended-release cefaclor must be taken within one hour after a meal; add meal-time alerts to discharge instructions so adolescents don't miss once-daily dosing.
Most reported 'penicillin allergies' in children are non-IgE rashes; document reaction details to avoid unnecessary broad-spectrum antibiotics.
Mild loose stools are common; counsel families on hydration and probiotics but advise evaluation if diarrhea is severe or bloody to rule out C. difficile.
Persistent fever or otalgia after 3 days warrants re-examination, culture-directed therapy, or ENT referral.